§432:1-604  In vitro fertilization procedurecoverage.  (a)  All individual and group hospital or medical service plancontracts which provide pregnancy-related benefits shall include in addition toany other benefits for treating infertility, a one-time only benefit for alloutpatient expenses arising from in vitro fertilization procedures performed onthe subscriber or member or the subscriber's or member's dependent spouse;provided that:

(1)  Benefits under this section shall be provided tothe same extent as the benefits provided for other pregnancy-related benefits;

(2)  The patient is a subscriber or member or covereddependent of the subscriber or member;

(3)  The patient's oocytes are fertilized with thepatient's spouse's sperm;

(4)  The:

(A)  Patient and the patient's spouse have ahistory of infertility of at least five years' duration; or

(B)  Infertility is associated with one or moreof the following medical conditions:

(i)  Endometriosis;

(ii)  Exposure in utero to diethylstilbestrol, commonlyknown as DES;

(iii)  Blockage of, or surgical removal of, one orboth fallopian tubes (lateral or bilateral salpingectomy); or

(iv)  Abnormal male factors contributing to theinfertility;

(5)  The patient has been unable to attain asuccessful pregnancy through other applicable infertility treatments for whichcoverage is available under the contract; and

(6)  The in vitro fertilization procedures areperformed at medical facilities that conform to the American College ofObstetric and Gynecology guidelines for in vitro fertilization clinics or tothe American Society for Reproductive Medicine minimal standards for programsof in vitro fertilization.

(b)  For the purposes of this section, the term"spouse" means a person who is lawfully married to the patient underthe laws of the State.

(c)  The requirements of this section shallapply to all hospital or medical service plan contracts delivered or issued fordelivery in this State after June 26, 1987. [L 1987, c 332, §2 and L 1989, c276, §4; am L 2003, c 212, §122]